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Are you a Veteran of the Canadian Armed Forces or the Royal Canadian Mounted Police?
*
No
Yes
Are you at least 18 years old?
*
No
Yes
Do you currently live in Canada?
*
No
Yes
old? days 20+35=
Are you comfortable reading and writing in English or French?
*
No
Yes
What was your sex at birth?
*
Female
Male
What is your gender?
*
Woman
Man
Other
Please specify "Other":
*
Province / Terrirory
*
Please select your Province / Territory
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Best days to call you:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Best time of day to call you:
Mornings
Afternoons
Evenings
Name
*
First
Last
Email
*
Phone
*
Our team will call this phone number to confirm that you are eligible for the study. If we cannot reach you, we cannot enroll you.
Slide to select the correct answer: 20+35=
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